Medicare Agency Hits Good Samaritan Hospital With “Notice of Termination”

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Editor’s Note: A previous version of this story noted that Good Samaritan Hospital’s CEO sent an email to staff earlier this week saying the Centers for Medicare and Medicaid Services sent the hospital a notice of Immediate Jeopardy. HCA Healthcare, the hospital’s parent company, corrected Good Sam’s CEO initial statement Wednesday, saying the hospital received a “Notice of Termination” rather than a notice of “Immediate Jeopardy.” This article has been updated to reflect that.

Federal regulators from the Centers for Medicare and Medicaid Services (CMS) have issued a “Notice of Termination” to San Jose’s Good Samaritan Hospital, according to the hospital’s parent company, HCA Healthcare.

A “Notice of Termination” typically warns hospitals that CMS plans to terminate Medicare or Medicaid agreements unless certain deficiencies are corrected.

If the termination is finalized, CMS will no longer pay that hospital to care for Medicare or Medicaid patients.

On Tuesday, NBC Bay Area obtained an internal email from Good Samaritan CEO Tomi Ryba to hospital staff saying Good Samaritan had received a notice of “Immediate Jeopardy” from CMS, calling the findings “serious” and saying they related to “Governing Body and Nursing Services.”

“I am in receipt of a notice of Immediate Jeopardy from CMS (Medicare), which places our Medicare contract at risk of termination unless we fully remediate all deficiencies that were identified in the recent CMS Complaint Violation Survey,” Ryba said.

Ryba goes on to say that Good Sam “shall come into full compliance, to be validated by a second CMS Survey, likely within the next sixty days.”

The following day, however, HCA Healthcare corrected Ryba’s statement, saying CMS had sent a “Notice of Termination” rather than a notice of “Immediate Jeopardy.”

“Initially, we received an incomplete report from CMS with 27 pages missing,” HCA spokesperson Janine De la Vega said in a statement. “When we reviewed the report in its entirety the next day, it was clear that CMS issued a Notice of Termination, not an Immediate Jeopardy.”

De la Vega said the deficiencies CMS noted “did not cause serious injury, harm, impairment or death to a patient” and that “while we have serious issues to address, none of the items outlined caused harm to patients and we are committed to correcting them within the 90 day window allotted by CMS.”

The exact nature of the violations found by inspectors is unclear, as their report hasn’t yet been publicly posted, but HCA said “there’s been no demonstrated harm to patients.”

Federal regulators from the Centers for Medicare and Medicaid Services (CMS) have issued a notice of “Immediate Jeopardy” to San Jose’s Good Samaritan Hospital, NBC Bay Area’s Investigative Unit has confirmed. Investigative Reporter Candice Nguyen reports.

This all comes after an NBC Bay Area investigation last month revealing health inspectors were actively probing a multitude of complaints recently submitted by nurses to the California Department of Public Health, mostly around staffing shortages.

“Oh, it’s scary some days going into work,” said Diana Rossman, a nurse in the hospital’s high-risk antenatal until. “You don’t know what type of staffing you’re going to walk into.”

Good Samaritan nurses have been protesting what they call dangerously low staffing levels for more than a year, staging walkouts and presenting grievances to hospital management.

Many of the staffing complaints from nurses come from Good Samaritan’s labor and delivery department, where public health inspectors found four separate staffing violations in 2019 alone.

“A review of staffing records for the week of 8/11/19 to 8/17/19 indicated mandatory staffing ratios were not met on 5 of 7 days (8/11, 8/12, 8/13, 814, and 8/16),” one such report states.

Last month, state lawmakers blasted executives from Good Samaritan Hospital and its parent company HCA Healthcare for “dangerous” safety practices and staffing levels.

“This has really just been an ongoing concern,” State Sen. Dave Cortese at the time. “There seems to be some level of tone deafness, some level of lack of concern and compassion.”

NBC Bay Area will update this story once the complete inspection report and notice of termination are released.

Candice Nguyen is an investigative reporter with NBC Bay Area. Contact her about this story or any others by emailing

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